title: Cross-reacting carbohydrate determinants and hymenoptera venom allergy.
abstract: OBJECTIVE
  Insect venom allergy is an important cause of anaphylaxis. Venom immunotherapy assume the clear identification of the culprit insect, but this is impeded by Immunoglobulin E (IgE) antibodies to cross reactive carbohydrate determinant (CCD) epitopes of common glycoproteins. Here we give an overview about inducers, importance, and relevance of anti-N-Glycan CCD IgE antibodies.
  
  
  RESULTS
  Pollen exposure and insect stings induce anti-CCD IgE antibodies interfering with in-vitro tests for allergy diagnosis due to extensive IgE cross-reactivity. Instead of being biologically active these antibodies are irrelevant for allergic reactions due to hymenoptera stings. The general response of the immune system to the ubiquitous exposure to N-glycan containing glycoproteins is still a matter of debate. CCD specific IgG antibodies in sera of bee keepers suggest tolerance induction due to high-dose exposure. Tolerance induction by pollen and food glycoproteins has not been proved.
  
  
  CONCLUSIONS
  Hymenoptera stings and pollen exposure induce anti-CCD IgE. In regard to anaphylaxis due to Hymenoptera stings these antibodies are not clinically relevant, but they are important for the specificity of in-vitro tests proving insect venom allergy. The introduction of component based diagnostic IgE testing improves the specificity of in-vitro tests if proteins devoid of CCD epitopes are used.
authors.affiliation: Department of Dermatology, University Hospital Muenster, Muenster, Germany. r.brehler@uni-muenster.de
authors.forename: Randolf
authors.initials: R
authors.lastname: Brehler
authors.forename: Sonja
authors.initials: S
authors.lastname: Grundmann
authors.forename: Benedikt
authors.initials: B
authors.lastname: Stöcker
mesh_terms: D000818:Animals; D001180:Arthropod Venoms / Q000009:adverse effects / Q000276:immunology*; D002241:Carbohydrates / Q000276:immunology*; D003429:Cross Reactions; D000939:Epitopes / Q000276:immunology*; D006023:Glycoproteins / Q000276:immunology; D006801:Humans; D006927:Hymenoptera; D006967:Hypersensitivity / Q000209:etiology / Q000276:immunology / Q000628:therapy; D007108:Immune Tolerance / Q000276:immunology; D007073:Immunoglobulin E / Q000276:immunology; D007074:Immunoglobulin G / Q000276:immunology; D007299:Insect Bites and Stings / Q000150:complications / Q000276:immunology / Q000628:therapy; D011058:Pollen / Q000276:immunology
chemical_list: D001180:Arthropod Venoms; D002241:Carbohydrates; D000939:Epitopes; D006023:Glycoproteins; D007074:Immunoglobulin G; D007073:Immunoglobulin E